Cavity on a Tooth With a Porcelain Veneer

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I have four porcelain veneers. Recently, one of them developed a cavity. I went to see my dentist and he suggested we remove the porcelain veneer and replace it with a dental crown. Is this standard procedure? I don’t want to do that unless it is absolutely necessary because it is on a front tooth and I really like the veneer on it.

Perry

Dear Perry,

I wish I had some more details about your specific case, but I can give you some general suggestions. Unless your cavity is 20% or more of the tooth, I would say a dental crown would be an unnecessary overtreatment. There is something else to be aware of as well.

Dentists who tend to steer patients toward unnecessary crowns, generally do so because they are not expert cosmetic dentists. This is important to keep in mind because matching a single crown on a front tooth to a porcelain veneer is something only the top cosmetic dentists can do. Even then, it could take several try-ins before there is an exact match. I recommend getting a second opinion before moving forward with any of this.

Though I don’t know where your decay is, porcelain veneers are the most vulnerable around the margins where the porcelain and teeth come together. There are two things you can do that will help protect that area. The first is a general preventative for decay on all your teeth. Avoid frequent snacking. Believe it or not, your saliva is one of the best allies you have against tooth decay because of the bacteria fighting minerals it contains. However, the more you snack, the less of an opportunity it has to do that fighting and the more bacteria is allowed to flourish. A second thing you can do is make sure you are flossing daily. More patients skip that than are willing to admit it.

I hope this helps. Please get that second opinion from someone with post-doctoral training in cosmetic dentistry.

This blog is brought to you by Arnold, MD Dentist Dr. Meredith Esposito.